Randomized double-blind placebo controlled study of preinduction cervical priming with 25 µg of misoprostol in the outpatient setting to prevent formal induction of labour

Abstract

Objective: To compare the efficacy of preinduction outpatient use of a single dose of 25 μg vaginal misoprostol between 38^1/2 and 40 weeks with that of placebo, to decrease the interval from intervention to delivery after stretch and sweep in low-risk gravid women with Bishop's score <4.

Method: Sixty three women received 25 μg vaginal misoprostol and 63 women received placebo after stretch and sweep.

Results: The duration from intervention to delivery was 3.35 (1.12-9.46) days in the misoprostol group and 5.42 (2.39-10.11) days in the placebo group which was statistically significant (p = 0.029). Spontaneous labor was seen in 39 women (61.9 %) in the misoprostol group and 35 women (55.6 %) in the placebo group (p = 0.531). Eight women in the misoprostol group and 18 in the placebo group had Lower Segment Caesarean Section (LSCS) and this difference was also statistically significant (p = 0.027). There were no major maternal and neonatal complications in both groups.

Conclusion: Preinduction use of 25 μg vaginal misoprostol after stretch and sweep in the outpatient setting decreased the intervention to delivery interval when compared to placebo.

Keywords: Cervical priming; Intervention to delivery interval; Misoprostol; Outpatient; Postdated pregnancy; Preinduction.